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Calorically Dense Pediatric Enteral Formula

Washington rates for HCPCS B4160

Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Rates data updated July 2026.

How much does Calorically Dense Pediatric Enteral Formula cost?

$0.34

Typical negotiated rate. In Washington, July 2026.

Insurers have agreed to pay about $0.34 for this service. The price depends on where it is billed: about $0.34 from a physician practice, and about $0.79 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$0.34$0.34 to $0.34
FacilityA hospital or hospital-owned outpatient department$0.79$0.79 to $1.78

How much rates vary

Facilitymedian $1 · 10th to 90th $0 to $2Professionalmedian $0 · 10th to 90th $0 to $0
$0.5$1$2facility $1professional $0

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.34
Median
$0.34
Typical High
$0.34
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.32
Median
$0.34
Typical High
$0.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.42
Median
$0.42
Typical High
$0.42
Molina
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$75.86
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$0.79
Median
$0.79
Typical High
$0.79
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.48
Median
$1.86
Typical High
$2.57
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$0.76
Median
$0.76
Typical High
$1.32

Where Washington sits

The same service costs 4.6 times more in North Dakota than in Rhode Island. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington· 44th of 51

$0.34

ND $1.51RI $0.33

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.